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Endovascular Treatment of Arterial Complications After Liver Transplantation: Long-Term Follow-Up Evaluated on Doppler Ultrasound and Magnetic Resonance Cholangiopancreatography

  • Clinical Investigation
  • Arterial Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate long-term arterial patency and abnormalities of bile ducts in patients that had endovascular treatment for arterial complications after liver transplantation (LT).

Materials and Methods

Between 2004 and 2014, 1048 LTs were consecutively performed in our institution and 53 patients (42 men; age range 19–69) were diagnosed and treated by endovascular techniques for arterial complications such as stenosis, thrombosis, dissection or kinking of the hepatic artery (HA). Radiological and surgical data were retrospectively analyzed, and survivors were contacted to undergo follow-up Doppler ultrasound (DUS) of the HA and magnetic resonance cholangiopancreatography.

Results

The primary technical success of endovascular treatment was 94% (n = 50). The patency rate of HA at 5-year was 81%. After a median follow-up of 58 months, 17 patients (32%) developed radiological features of ischemic cholangiopathy (IC), including 7 patients with abnormal DUS and 10 with normal DUS. Patients who presented with complications of the HA in the first 3 months after LT developed IC more frequently (42%) than others (12%) (p = 0.028). No other factor was associated with the development of IC.

Conclusion

IC was more often observed when HA complication occurred within the first 3 months after LT. The presence of IC was not excluded by a normal DUS during follow-up.

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Abbreviations

CDT:

Catheter-directed thrombolysis

CI:

Confidence interval

DUS:

Doppler ultrasound

HA:

Hepatic artery

IC:

Ischemic cholangiopathy

MDCT/A:

Multidetector-computed tomography/arteriography

MRCP:

Magnetic resonance cholangiopancreatography

LT:

Liver transplantation

PTA:

Percutaneous transluminal angioplasty

PACS:

Picture archiving and communication system

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Authors and Affiliations

  1. Department of Radiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland

    Romain Breguet, Lawrence Pupulim & Sylvain Terraz

  2. Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland

    Romain Breguet, Lawrence Pupulim & Sylvain Terraz

  3. Department of Hepatobiliopancreatic Surgery, Hôpital Beaujon, UNITY Hospitalo-Universitary Department, Hôpitaux Paris Nord Val de Seine (AP-HP), Clichy, France

    Federica Dondero & Ailton Sepulveda

  4. Department of Gastroenterology and Hepatology, University Hospitals of Geneva, Geneva, Switzerland

    Nicolas Goossens

  5. Department of Hepatology, Hôpital Beaujon, Hôpitaux Paris Nord Val de Seine (AP-HP), Clichy, France

    Claire Francoz, François Durand, Valérie Vilgrain & Maxime Ronot

  6. Sorbonne Paris Cité, CRI, U1149, Paris Diderot University, Paris, France

    Claire Francoz, François Durand, Valérie Vilgrain & Maxime Ronot

Authors
  1. Romain Breguet
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  2. Federica Dondero
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Correspondence to Romain Breguet.

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The authors declare that they have no conflict of interest.

Ethical Standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Breguet, R., Dondero, F., Pupulim, L. et al. Endovascular Treatment of Arterial Complications After Liver Transplantation: Long-Term Follow-Up Evaluated on Doppler Ultrasound and Magnetic Resonance Cholangiopancreatography. Cardiovasc Intervent Radiol 42, 381–388 (2019). https://doi.org/10.1007/s00270-018-2108-8

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  • DOI: https://doi.org/10.1007/s00270-018-2108-8

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